Valuing the Girl-Child to Better Meet her Health and Well Being Needs Dr Ruth Yeoman, Research Fellow, University of Oxford

Valuing the Girl-Child to Better Meet her Health and Well Being Needs The Problem: India Context - High levels of anaemia in adolescent girls, resulting from poor nutrition, limited community understanding and inadequate public health services. Need to deliver new services to more than 90 communities by end 2018 Requirement to demonstrate impact of new model across measures of malnutrition, infant and maternal mortality, incidence of future disability. How the project could respond: Generating scalable community-level change by learning from participatory interventions in rich action contexts. Connecting deep local change to ecosystem responses in institutions, policy making and national frameworks. Embedding sustainable local, regional and national innovations in public health, nutrition and social/cultural practices

A Thinking, Feeling and Acting Model for Deep Local Change Valuing the Girl-Child Ethical Thinking (Moral) Examining the values, norms and assumptions underpinning how the girl-child is understood and valued Collaborative Knowledge Building (Acting) With a multi-stakeholder, ‘whole system’ expert group create a scalable model grounded in a rich understanding of one or more local action contexts (communities) Cognitive Emotions (Feeling) Sensitising the expert group through empathy and care ethics to the needs of the Girl-Child, and connecting this to the needs of the family/community/state Data Synthesis (Reason) Use health, nutrition and community data (quantitative and qualitative) to examine the tensions, challenges and paradoxes in system responses to valuing the girl-child

Aspects of the Model for Change Systems approach, expansive learning and values-oriented A systems approach to expanding and enriching our knowledge of the Girl-Child using: Ethical values (moral) Health and well-being data (reasoning) Emotional sensitivity (feeling) Developing and using this knowledge with an ‘expert group’ of local community members and specialists. Focus on a pilot with a small cohort of communities (acting) Use participatory methods, such as Change Laboratories, photovoice, theatre, to generate the collaborative knowledge and shared expertise needed for cultural adaptation, innovation and change. Securing strategic cover by connecting, through expanding circles of concern, to regional and national stakeholders through workshops Perhaps supported by a Policy Making Delphi conversation Action-oriented Provides replicable learning for other communities.

The Expert Group in Expanding Circles of Concern National level/strategic cover Policy makers Government National institutions International stakeholders Private sector partners Expert Group Girls/boys Parents/carers Teachers Community elders Govt health workers Others in the system Local/Regional Institutions NGOs Public Health Organisations Education/schools Others?

Questions Tensions/Challenges/Paradoxes Some indicative questions – very general at the moment: ‘The System’ – what does the system look like? What is the history of the system? (successes/failures/memory/legacy). How does it need to be redesigned? Are there any system leaders/orchestrators? Cultural norms and assumptions – What cultural norms impede an expanded and enriched understanding of the Girl-Child? Power – where does power lie? How does it need to be redistributed? Who are the local, regional and national stakeholders? What technical, social and material resources do they have? What is the level of trust? What do the relationships look like? Are there any communities which are particularly ready for change? That is – they feel a sense of urgency, are committed to doing something, are ready to learn and work with each other (locally and at other levels). What are the general capabilities of ‘the system’ to orchestrate change?

Dr Ruth Yeoman, BSc, MBA, PhD Centre for Mutual and Employee-owned Business Kellogg College, University of Oxford. ruth.yeoman@kellogg.ox.ac.uk